MOD.A National Home Modification Conference:
Modifying the Home – Building Inclusion Practice – 28th & 29th April, Canberra, Australia.
Notes from day one of the conference taken by our CEO – Shalla Thomas.
INTERNATIONAL AND AUSTRALIAN PERSPECTIVES, CHALLENGES AND APPROACHES:
Paul Smith, UK
The UK model of home handyperson services, funding from health.
Run by housing, Local Government, Charities and Private companies, available in 85% of districts, usually commissioned by Local Government.
Means tested for over 18 year olds, under 18 year olds $30,000 available to modify.
Modifications delay entry to residential care by at least 4 years, save a lot of money by keeping people safely at home.
550 million pounds by 2019/20 – challenge to spend it better; 40,000 grants annually.
Inclusion by Design: 15% of worlds population have disabilities, ageing population increasing, births decreasing.
Prepare home for a good life. Design disconnect.
Action is all in retrofit only 2% in new build. Collaboration.
Aboriginal housing: need two entrances, cultural reasons.
Point of sale information to avoid DIY disasters.
Follow up has not been integral part of industry
HOME MODIFICATIONS IN DISABILITY AND AGED CARE REFORM:
Karen Pickering, Aged Care Reforms
February 2017 Home Care Package will follow client
July 2018 Integration of Home Care Package and CHSP as a single care at home program.
User Rights Principles, May 2016 www.homecaretoday.org.au
Aged Care Roadmap
Dr Lloyd Walker, Assistive Technology National and International
3 Key pillars:
- Insurance approach
- Choice and Control
- Community and mainstream
Expectations lift and grow, support depends on what person chooses to achieve
NDIS AT Strategy:
Structual work or local authority permit considered complex modification
Home Modifications 1 – 6% of plans
Over $2m claimed, majority 35 year olds + for bathroom modifications, ramps, lifts/hoists, advice.
Change, opportunity, innovation- About meeting participant goals not the modification – solution focus, creative ways to get better outcomes
AT Innovation Hub, scoping study July, Design and Service innovation
Proven effective early intervention
Innovation around practice, products, price, quality and timeliness
Making homes liveable for the future
CONSUMER FOCUSED HOME MODIFICATIONS:
WA Assessment Framework
RAS 2012, 4 years ahead: increase in HM and AT based on wellness and re-ablement; 50% difficulties can be overcome by modification.
Consumer decision making: what, why and when
Single point of access and advice
Outcome: improved independence and quality of life
Speed of access/waitlists; retail/mainstreaming
Consumer focussed platform: Best practice Scoping Review; re-ablement interface
Fast track home mods to support re-ablement – Process and client journey
Toolkit: templates, decision making protocols guidelines
Consumer Capacity: competency framework; client expectations
The real value argument: reducing the cost of care, and provide freedom
BEST PRACTICE IN HOME MODIFICATION SERVICE DELIVERY:
Develop a sustainable service model, Maintain independence and wellbeing
Ongoing maintainence of equipment
Upskill RAS and advisory line – Person centred approach higher likelihood of uptake in modifications.
Earlier intervention can result in cheaper solutions or encourage self funded
Focus on physical function rather than medical diagnosis
OT standardised assessment tool for HM on function and environment, follow up essential – Use of non health professionals
Clear visuals of HM ie ipad
Consumer workshops – reasonable and necessary does not fit with consumer choice
HOME MODIFICATIONS/ASSISTIVE TECHNOLOGY – BUILDING INCLUSION, PRACTICE AND COST-EFFECTIVE DESIGN:
Height Adjustable Products, products that adapt to you
Swedish products since 1950’s/1970’s
Who benefits? Client and carer, room/facility
Design principles: goals and outcomes
NDIS OT $172.13 per hour
$11,915 for kitchen or 1 hour care each day over one year = $17,687.28, minimum savings in first year $5,772; savings over 10 years $176,873.
THE FUTURE OF THE HOME MODIFICATIONS INDUSTRY:
Jennifer Barron, Practical Work Solutions
Quality challenges – no quality system set exists currently to be accredited by (JAS-AU/NZ) in principal support NDIA and MAC.
Danny Gibson, Hunter Home Modifications
Operation NDIS trial zone 2013 (5 p’s from father)
Service flexibility of client demands; OT’s; contractual issues with NDIA;
New clients want bells and whistles – Maintain functional within the demands
CHSP builders only ones to do NDIS major modifications
Reasonable and Necessary OT’s must justify recommendations
Contracts over $5,000 NDIA do not sign contracts, build and project management acceptance of quote inferred contract in place
Door automation high demand
Regulated equity release in the home to pay for home modifications
HOUSING AFFORDABILITY AND MAKING HOUSING MORE ACCESSIBLE FOR PEOPLE WITH DISABILITY:
Housing affordability increasingly problematic.
98% population in capital cities, with highest concentration on coastlines.
Rental affordability even worse, no affordable rentals in cities, pushed into choices of too high rent or down to standard of accommodation, ie marginal housing options, shortfall 500,000 properties
Homelessness older women becoming more vulnerable $150m required to incentives to attract private sector, all built to universal design.
Mike Allen report 460,000 NDIS participants, 150,000 move into alternative housing over 10 years still shortfall 35,000 probably more like 50 – 80,000.
Standards based on principles of inclusion.
Housing Position Statement – Advocacy Document
- choice (principle driving factor)
Higher building design codes – enforceable
Better design; inclusionary zoning; transport corridors; shared equity; (WA)
National HM Program: promote retrofit as sexy and universally accepted
THE EFFECTS OF HOME MODIFICATIONS ON CARE-GIVING AND QUALITY OF LIFE:
Dr. Phillipa Carnemolla, Uni of NSW
4 year of PHD
The human experience of housing measures changes in wellbeing and home modifications
Health and social outcomes
157 HACC Home Mods clients
Average age 72 year old, 13% younger than 55; demand priority
- Bathroom Modification
- Access Modification
- Kitchen/Laundry Modification
Before modification 15.02 hours per week; after modification 8.70 hours per week average reduction of 42% per week.
63% reduction in assisted showering; 41% reduction in mobility assistance around the home; 47% reduction in support at toilet; reduce care needs 42%; increased wellbeing by 47%
Incentives for care providers to recommend home mods reduces their income.
Recommend to introduce housing screen, then housing first, visitability important.
Qld housing providers work well with community sector for best end result for client.
THE STATE OF THE NATION’S HOUSING – WHAT VICTORIAN INSPECTIONS ARE TELLING US:
Frank Ortolan, Archicentre, Vic
1998: bathroom and access issues.
Provide reports to individuals, 75000 reports provided free of charge, 60+ or have a disability and/or DVA card
Application to State Wide Equipment Program (SWEP) ($4400 only) free and fee for service
- Health and Safety
- Repair and Maintenance
- Energy and Water use
Archicentre standard step/ramp details – Dept Health and Human Service loan at reduced interest rate up to 15 years repayment
18 architects, 96% satisfaction rating
Trip and slip hazards highest fault in home, then electrical, roof, cracking and timber rot
Average cost of ramp range (2016) $4,953 – $6,189
Cut out baths not best outcome but they do them in certain circumstances
High conversion rate of reports to home modification
Dictate to master plans – legislation and state government masterplans
What makes a home for people?